Healthcare Provider Details

I. General information

NPI: 1457063133
Provider Name (Legal Business Name): DESIREE BRIANNE WRIGHT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/14/2022
Last Update Date: 12/14/2022
Certification Date: 12/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2751 US-19 BUS
ANDREWS NC
28906
US

IV. Provider business mailing address

904 MOUNTAIN TOP DR
MURPHY NC
28906-9704
US

V. Phone/Fax

Practice location:
  • Phone: 828-321-4510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberWRIG-MGY6C
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: